Verbal fluency (VF) tasks are typically scored by the number of acceptable words generated within an allotted time (i.e., total score). However, total scores do not provide insight into verbal and executive processes underlying VF task performance. Further analyses have been implemented to increase the analytical power of VF tasks, but systematic scoring guidelines are needed. We generated instructions for administration, scoring, and analyses of total scores, errors, temporal parameters, clustering, and switching with strong inter-rater reliability. To investigate the reliability of the proposed analysis, we modeled the performance of Finnish-speaking older adults (N ¼ 50) in phonemic (/k/, /a/, and /p/) and semantic (animals) categories. Our results are in line with previous studies: We observed a higher performance on semantic than phonemic fluency (p 0.001, d ¼ 0.91) and significant effects for education (p 0.001, d ¼ 1.11) and gender (p 0.001, d ¼ À1.11), but not for age (p ¼ 0.10, d ¼ 0.48). Most errors were repetitions. Performance declined over the allotted time frame as measured in 15-s segments (all ps < 0.001 with medium to large effect sizes). Task congruent clustering and switching were productive strategies (all ps < 0.001 with large effect sizes), and participants generated task discrepant clusters in both phonemic (p ¼ 0.004, d ¼ 0.69) and semantic tasks (p ¼ 0.66, d ¼ 0.18). The results substantiate the proposed method, providing evidence that these guidelines are a reliable starting point for VF task performance analyses in various clinical populations investigating VF task performance in depth.
Verbal fluency (VF) tasks are typically scored by the total number of acceptable words generated within an allotted time (i.e., total score). VF task total scores can differentiate groups such as healthy subjects and patients, but they do not provide insight into the linguistic and cognitive processes underlying VF performance. To increase the analytical and explanatory power VF tasks can carry, further analysis of errors, temporal parameters, clustering, and switching have been implemented. Systematic scoring guidelines are needed for VF task analysis to be comparable across studies. In this pilot study, we generated detailed instructions for language- specific administration, scoring, and analyses of VF tasks to increase the reliability and validity across studies implementing VF tasks. We demonstrate the analysis for total scores, errors, temporal parameters, task congruent and task discrepant clustering, and switching with strong inter-rater reliability in three phonemic (/k/, / a/, and /p/) and one semantic (animals) category with data of healthy, Finnish speaking adults (N = 50). Our results show that all proposed analyses contribute to VF task performance. We discuss the importance of systematic guidelines and analyses and believe that our analysis on a representative sample of healthy, older monolingual speakers can provide guidance and a starting point for specific VF task performance analyses in various clinical populations.
Semantic tasks are frequently used when examining language functions in patients with acquired disorders such as Alzheimer's disease (AD) and aphasia. Little is known about the possible covariation between different types of tasks or their factor structure in healthy adults. Additionally, few studies have examined semantic task performances in different patient groups. The aims of this data-driven study were to examine the factor structure in a wide range of semantic tasks in healthy older adults, the possible differences in factor variables between healthy controls, patients with AD and patients with stroke aphasia, as well as the clinical applicability of tasks in differentiating the two patient groups from controls. Participants included 59 healthy older adults, 13 patients with AD and 14 patients with aphasia. The results indicated a four-factor solution for the semantic task variables: (1) the Semantic association factor, (2) the Time factor, (3) the Verbal factor and ( 4) the Synonym factor. The Verbal factor was the only distinguishing factor between the two patient groups. Three factors reliably discriminated between the controls and the AD patients, and the Verbal factor reliably discriminated between the controls and the aphasia patients. In addition, a few single task variables showed outstanding discrimination for both patient groups. This study supports the notions of semantic tasks tapping into more than one cognitive subcomponent and a more general semantic impairment in AD than in aphasia. In clinical assessment, choosing appropriate semantic tasks is crucial in order to reliably detect the characteristics of the impairment.
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